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Unravelling the impact of insecticide-treated bed nets on childhood malaria in Malawi
BACKGROUND: To achieve malaria elimination it is essential to understand the impact of insecticide-treated net (ITNs) programmes. Here, the impact of ITN access and use on malaria prevalence in children in Malawi was investigated using Malaria Indicator Survey (MIS) data. METHODS: MIS data from 2012...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837906/ https://www.ncbi.nlm.nih.gov/pubmed/36635658 http://dx.doi.org/10.1186/s12936-023-04448-y |
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author | Tangena, Julie-Anne A. Mategula, Donnie Sedda, Luigi Atkinson, Peter M. |
author_facet | Tangena, Julie-Anne A. Mategula, Donnie Sedda, Luigi Atkinson, Peter M. |
author_sort | Tangena, Julie-Anne A. |
collection | PubMed |
description | BACKGROUND: To achieve malaria elimination it is essential to understand the impact of insecticide-treated net (ITNs) programmes. Here, the impact of ITN access and use on malaria prevalence in children in Malawi was investigated using Malaria Indicator Survey (MIS) data. METHODS: MIS data from 2012, 2014 and 2017 were used to investigate the relationship between malaria prevalence in children (6–59 months) and ITN use. Generalized linear modelling (GLM), geostatistical mixed regression modelling and non-stationary GLM were undertaken to evaluate trends, spatial patterns and local dynamics, respectively. RESULTS: Malaria prevalence in Malawi was 27.1% (95% CI 23.1–31.2%) in 2012 and similar in both 2014 (32.1%, 95% CI 25.5–38.7) and 2017 (23.9%, 95% CI 20.3–27.4%). ITN coverage and use increased during the same time period, with household ITN access growing from 19.0% (95% CI 15.6–22.3%) of households with at least 1 ITN for every 2 people sleeping in the house the night before to 41.7% (95% CI 39.1–44.4%) and ITN use from 41.1% (95% CI 37.3–44.9%) of the population sleeping under an ITN the previous night to 57.4% (95% CI 55.0–59.9%). Both the geostatistical and non-stationary GLM regression models showed child malaria prevalence had a negative association with ITN population access and a positive association with ITN use although affected by large uncertainties. The non-stationary GLM highlighted the spatital heterogeneity in the relationship between childhood malaria and ITN dynamics across the country. CONCLUSION: Malaria prevalence in children under five had a negative association with ITN population access and a positive association with ITN use, with spatial heterogeneity in these relationships across Malawi. This study presents an important modelling approach that allows malaria control programmes to spatially disentangle the impact of interventions on malaria cases. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12936-023-04448-y. |
format | Online Article Text |
id | pubmed-9837906 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-98379062023-01-14 Unravelling the impact of insecticide-treated bed nets on childhood malaria in Malawi Tangena, Julie-Anne A. Mategula, Donnie Sedda, Luigi Atkinson, Peter M. Malar J Research BACKGROUND: To achieve malaria elimination it is essential to understand the impact of insecticide-treated net (ITNs) programmes. Here, the impact of ITN access and use on malaria prevalence in children in Malawi was investigated using Malaria Indicator Survey (MIS) data. METHODS: MIS data from 2012, 2014 and 2017 were used to investigate the relationship between malaria prevalence in children (6–59 months) and ITN use. Generalized linear modelling (GLM), geostatistical mixed regression modelling and non-stationary GLM were undertaken to evaluate trends, spatial patterns and local dynamics, respectively. RESULTS: Malaria prevalence in Malawi was 27.1% (95% CI 23.1–31.2%) in 2012 and similar in both 2014 (32.1%, 95% CI 25.5–38.7) and 2017 (23.9%, 95% CI 20.3–27.4%). ITN coverage and use increased during the same time period, with household ITN access growing from 19.0% (95% CI 15.6–22.3%) of households with at least 1 ITN for every 2 people sleeping in the house the night before to 41.7% (95% CI 39.1–44.4%) and ITN use from 41.1% (95% CI 37.3–44.9%) of the population sleeping under an ITN the previous night to 57.4% (95% CI 55.0–59.9%). Both the geostatistical and non-stationary GLM regression models showed child malaria prevalence had a negative association with ITN population access and a positive association with ITN use although affected by large uncertainties. The non-stationary GLM highlighted the spatital heterogeneity in the relationship between childhood malaria and ITN dynamics across the country. CONCLUSION: Malaria prevalence in children under five had a negative association with ITN population access and a positive association with ITN use, with spatial heterogeneity in these relationships across Malawi. This study presents an important modelling approach that allows malaria control programmes to spatially disentangle the impact of interventions on malaria cases. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12936-023-04448-y. BioMed Central 2023-01-13 /pmc/articles/PMC9837906/ /pubmed/36635658 http://dx.doi.org/10.1186/s12936-023-04448-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Tangena, Julie-Anne A. Mategula, Donnie Sedda, Luigi Atkinson, Peter M. Unravelling the impact of insecticide-treated bed nets on childhood malaria in Malawi |
title | Unravelling the impact of insecticide-treated bed nets on childhood malaria in Malawi |
title_full | Unravelling the impact of insecticide-treated bed nets on childhood malaria in Malawi |
title_fullStr | Unravelling the impact of insecticide-treated bed nets on childhood malaria in Malawi |
title_full_unstemmed | Unravelling the impact of insecticide-treated bed nets on childhood malaria in Malawi |
title_short | Unravelling the impact of insecticide-treated bed nets on childhood malaria in Malawi |
title_sort | unravelling the impact of insecticide-treated bed nets on childhood malaria in malawi |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837906/ https://www.ncbi.nlm.nih.gov/pubmed/36635658 http://dx.doi.org/10.1186/s12936-023-04448-y |
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